James is an experienced product manager at a large device company. He has a winning new population health idea supported by a strong business case.

James knows his new initiative will pivot the company well for the future of value-based reimbursement. He also knows that maintaining the status quo will be a death knell as the fee-for-service paradigm gradually disappears.

James has solid ROI projections and trend analytics to back it all up. He also knows his idea fits and delivers on the CEO’s stated vision for the company’s future. He has pitched the idea up the management chain internally on several occasions.

The problem is James is not getting the support he needs from upper management. He gets heads nodding but no action. No commitment. Overall lukewarm reception.

Why? Because even though what James is proposing is sensible, timely, backed by facts, and aligned with the corporate vision, it requires going in a direction that is unfamiliar to the company. It is perceived as an unknown. It is therefore seen as risky business.

What should James do? It doesn’t make sense to simply repeat the same arguments and expect a different result. He already made the best case he could. But he knows the window for competitive advantage is slipping away.

James needs other voices to give his bosses enough confidence to say yes and invest in what they know is a good idea and necessary for the company’s long-term viability, despite their concerns. These other voices need to be strong enough to overcome fear of change, fear of moving into an unfamiliar space.

James doesn’t need a large quantity of voices. Survey numbers won’t make his case more persuasive. The status quo thinking he needs to overcome is not rational. He needs to strategically manage relationships with his internal customers. Persuasion at an emotional level if required.

Specifically, James needs smart, influential people that genuinely share his thinking and who his bosses will listen to with open minds. That means select key opinion leaders and perhaps several important customers who will voice their agreement with three things: 1) The underlying premise about healthcare’s inevitable shift toward population health management and value-based reimbursement. 2) The recommendation to take proactive action now in order to be positioned to serve healthcare customers in the impending new business reality without losing viability in the current fee-for-service environment. 3) The reality that not taking action is the riskier choice.

The insights and recommendations need to be delivered carefully and strategically to be heard and take hold. Even if these influential voices are only echoing what James already said, when management hears it from them, it has a different impact. It shifts the perception of risk away from stepping into new territory, and toward missing the boat by not moving forward with Jame’s idea.

There’s a lot of science and research behind how and why this works from studies of persuasion and decision-making. But bottom line, and like-it-or-not, James needs to marshall additional resources to persuade his upper management to move forward and with sufficient investment. The end result is management’s initial fears of change are allayed, they feel reasonably confident that they are moving forward in the right direction, and most likely, they say yes!

A key promise of the population health phenomenon, so important to payors, providers, and suppliers is this: We need the public to get healthier. That requires participation. If payors pay, people will take advantage of free preventive services to get healthy.

Here’s how the Kaiser Family Foundation put it in their recent Health Reform overview (see bold): A key provision of the Affordable Care Act (ACA) is the requirement that private insurance plans cover recommended preventive services without any patient cost-sharing. Research has shown that evidence-based preventive services can save lives and improve health by identifying illnesses earlier, managing them more effectively, and treating them before they develop into more complicated, debilitating conditions, and that some services are also cost-effective. However, costs do prevent some individuals from obtaining preventive services. The coverage requirement aims to remove cost barriers.

The reality is that while cost is a barrier for some people, it’s not the only barrier. It may not even be the main barrier. Now you might be thinking, if preventive services have been proven to improve health and save lives, why would people NOT make use of them, especially when they’re free? What other barriers might there be?

In my two decades of experience working with CDC, CMS, FDA, and many public health efforts, behavior change is the holy grail. And maybe the hardest to achieve. The main barrier I believe is not money, but motivation. People will find all kinds of reasons (beyond costs) to NOT sign up for free preventive services, including: 1) I’m not sick, 2) I don’t need whatever those services are, 3) I’ll do it later.

Prevention has alway been a tough sell. The fundamental benefit promised is that something bad (illness) will not happen down the road. Many people don’t see that as compelling or personal relevant in a life with so many demands in the here and now.

The solution requires: 1) increasing immediate personal relevance, 2) making it simple to do. As my friend and colleague Peter Mitchell, head of Salter Mitchell’s MarketingForChange practice, says, make it fun, easy, and popular. Building on that, I like the FEFE acronym- Fun, Easy, Fast, Effective.

Research trends in the science of persuasion, behavioral economics and decision-making, social psychology, and marketing science, provide convergent evidence that motivating health behavior change and utilization of preventive services is no simple task, and requires far more than data, information, and logic.

Bottom line, population health players need to employ multiple approaches to motivate behavior change, and to not assume that a logical (and free) offer will do the job.

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FYI, here are a few more resources on motivating health behavior change:

Imagine your boss just surprised you with a $10,000 bonus. Would you be happy? Probably so. What if you now found out your boss gave your co-workers a $20,000 bonus. Still happy? Probably not.

Next, imagine you’re at an electronics store ready to buy a new high-end computer for $1,995. You use your phone to do a quick price check online and find the same computer at a competing store down the street for a bit less, $1,985. Would you go to the other store for the lower price? Probably not.

Now instead, imagine you’re at the same electronics store ready to buy a new calculator for $19.95. You check online and find the same calculator at the competing store down the street for less, $9.95. Would you go to the other store for the lower price? Probably so.

What’s going on??

What’s going on is that your frame of reference or “anchor” is changing. In the first bonus example, you compare $10,000 to $0 so of course you’ll be happy. You just gained $10,000. In the second bonus example, you compare your $10,000 to the $20,000 your co-workers got. Now you feel like you’re down $10,000 and you’re unhappy. However, from a rational perspective, it shouldn’t matter because in both scenarios you have $10,000 more than you did before.

In the electronics examples, the decision is about saving $10. However when you can save $10 on an almost $2,000 purchase, you feel it’s not worth the trouble of going to a different store. It’s only half of 1%. But when you can save $10 on a $20 purchase, you feel compelled to go to the other store. After all it’s saving 50%! But logically, it’s still $10 in both scenarios. And $10 is $10.

Anchoring is just one example from the rich field of behavioral economics that demonstrates how our mental accounting is not always logical or rational. It’s not necessarily a bad thing; it’s simply how most people operate. Knowing and understanding the powerful principles of behavioral economics and how to apply them in med tech marketing can help you appeal to customers in ways that better fit how they process information and make decisions.

Please share your examples of taking the anchoring principle into consideration (or not!) and tell us what resulted.